A silver medal's not good enough when it comes to nutrition

By Carolyn MacDonald 09 August 2016

A child undergoes nutritional screening in Angola. Proper nutrition is important for a child's first 1,000 days. Photo by: Maria Olsen / CC BY-NC-ND

It is good news that the second Nutrition for Growth event coincides with the 2016 Summer Olympics in Rio de Janeiro. Those of us who work to achieve Sustainable Development Goal 2 have much to learn about how to end malnutrition from this international sporting event.

Like the quadrennial competition, the N4G initiative — launched by former U.K. Prime Minister David Cameron at the London Games in 2012 — has global support and more than 100 partners from around the world. Governments, businesses, charities and more have pledged over $4 billion in new money to tackle malnutrition from 2013-2020. My organization, World Vision, was one of the charities, pledging $435 million for nutrition-specific interventions.

This international collaboration is crucial. We know how effective it is to invest in proper nutrition for a child’s first 1,000 days.

The wins? Reduced child deaths, improved learning, and better productivity as adults: all essential for sustainable development. For every $1 invested in proven nutrition programming, $16 of benefits are returned. Economic data released in May showed increased nutrition investment could result in $83 billion in gross domestic product growth across Africa alone.

We also know the dangers of insufficient investment: almost one-half of child deaths are due to undernutrition (3.1 million); 50 million at risk of death from the most acute form of malnutrition; and almost 1 in 4 (159 million) children are so malnourished that their minds and bodies will never fully develop. Africa and Asia losing up to 11 percent of GDP because of malnutrition.

As African Development Bank President Akinwumi Adesina, recently said: “Stunted children today means stunted economies tomorrow.” The estimated impact on the global economy of direct and indirect costs of malnutrition in all its forms could be as high as $3.5 trillion per year.

More gold to get gold

The reason for a second N4G event during this year’s Olympics is calculations indicating that without an additional $7 billion per year, on top of the $4 billion currently spent on priority nutrition-specific interventions, not even four of six nutrition targets can be achieved by 2025. Unless governments, business, donors and charities review their N4G pledges, and unless they commit more, the world won’t win big.

Something else to learn from the Olympics is the link between investment and success. It’s no secret that a country is more likely to win more medals the more it invests in its Olympic athletes. When it comes to ending malnutrition, it’s much as Kevan Gosper, Australian member of the International Olympic Committee, said when asked about a downturn in funding for Australian athletes: “The money is the difference between silver and gold.”

What worries me, though, perhaps even more than the current shortfall in funding is the dearth of trained professionals to implement nutrition interventions on the ground. Olympic athletes know that you need sustained, quality training to be able to go for gold.

A professional approach to winning

World Vision’s facilitated e-learning courses for the nutrition workforce are an alternative to the traditional face-to-face training workshops. Blended distance education has potential for scaling to more effectively address the capacity gap in the existing workforce right to community level, which is urgently needed.

Our facilitated distance e-learning goes beyond reading, lectures and taking quizzes online. These e-courses offer a practical and interactive learning experience for development workers — especially those who can’t travel and are closer to communities. They allow a person to learn at a slower pace than the traditional five-day workshops, develop critical analysis skills and apply learnings in their work contexts during the 6-12 week courses. They include image- and audio-rich online presentations and webcasts, featuring technically up-to-date content; forums for learners to discuss their work experiences; and practical assignments applying learning skills in communities. The facilitators are experts in public health nutrition programming, and provide live technical assistance, guidance and feedback, while recognizing and building on the expertise that the learners already have.

No train, no gain

World Vision, for example, works with government partners around the world to implement a package of interventions, in line with the countries’ national nutrition plans. Our 7-11 package for pregnant mothers and children includes interventions proven to reduce malnutrition, as outlined in the Lancet series. However, there can be a large capacity gap in those implementing nutrition interventions, both within our own organization and our partners’.

Tragically, research studies show that the current human capacity to implement evidence-based nutrition interventions is glaringly insufficient. There are limited professional training programmes in countries with the highest burden of malnutrition.

For example, while an estimated 2,000 trained nutrition professionals are needed for the West Africa region, currently there are only 700. Plus, nutrition interventions are often implemented by personnel from other disciplines, such as health and agriculture, and these personnel usually have little or no formal training or guidance on how to address the complex problems of malnutrition.

If we wait for colleges and universities to set up programs and graduate sufficient nutrition professionals it will be too late. The money that governments and others have committed will have been wasted because there wasn’t a concurrent systematic and coordinated investment in building the human capacity to carry out the evidence-based interventions.

Having seen the success of these courses in equipping practitioners from national to local levels, we are reaching out to funders and partners to scale them up. Partnering within the SUN Movement, and with regionally and nationally competent institutions, enables a coordinated and systemised capacity-strengthening approach that will reach the front lines. A little like the Altis training centers that offer Olympic athletes “an environment in which the elite track and field athlete can grow” and “puts quality before quantity in training,” we need to ensure that frontline staff are properly equipped to improve nutrition at the community level. Seventeen Altis-trained athletes were at the 2015 World Championships in Athletics and they won a gold, two silver and two bronze.

Imagine the impact on the children around the globe if the world invested $11 billion in ending malnutrition, and, at the same time invested in a coordinated and systematic equipping of the workforce to make that vision a reality. That would increase the return on investment. That would change the game.

Power of 5 is a global campaign in partnership with Amway, focused on raising awareness of the issue of childhood malnutrition, and the critical role nutrition plays in early childhood development. Learn more about the work of our partner and its micronutrient powder Nutrilite Little Bits here and join the conversation online using #powerof5.

About the author

Oped carolynmacdonald ed
Carolyn MacDonald

Carolyn MacDonald is nutrition director and founder of the Nutrition Center of Expertise at World Vision International. She holds an M.Sc. and a Ph.D. in nutrition from the University of Guelph. She has worked for over 25 years in international nutrition programming, policy and research, recently spearheading World Vision’s nutrition scale-up. She has also served as steering group member on the global Scaling Up Nutrition Civil Society Network since 2013. Learn more about World Vision’s nutrition work at http://wvi.org/nutrition.


Join the Discussion